The electrophysiologic actions of lidocaine and bupivacaine in the isolated, perfused canine heart. 1988

D M Wheeler, and E L Bradley, and W T Woods
Department of Anesthesiology, Johns Hopkins University, Baltimore, Maryland.

To discriminate between the electrophysiologic and arrhythmogenic effects of lidocaine and those of bupivacaine, isolated, perfused canine hearts were exposed to toxic concentrations of the drugs. The preparations included the sinus node and right atrium, and, in some cases, the AV node and interventricular septum as well. Action potentials were recorded from these areas, and right atrial twitch amplitude and spontaneous rate and rhythm were monitored. Heart rate was depressed in a dose-dependent manner by both drugs, as was atrial twitch amplitude. In the absence of arrhythmias, the spontaneous rate decreased less than 30% with lidocaine up to 50 micrograms/ml, and with bupivacaine up to 5 micrograms/ml. The twitch depression reflected a potency ratio for bupivacaine (mol. wt. 288) to lidocaine (mol. wt. 234) on a mass basis of 8.1:1. The most prominent arrhythmia found was sinoatrial block, which was caused by both drugs with a potency ratio for bupivacaine to lidocaine of 15.4:1 and was reversed by 0.02 microgram/ml norepinephrine. Sinus arrhythmias, block of retrograde conduction from AV node to atrium, and irregular rhythms originating within the AV node were observed with both drugs at concentrations similar to those which produced sinoatrial block. The atrial action potential revealed decreased upstroke velocity, overshoot, and height with both lidocaine and bupivacaine, with potency ratios (bupivacaine:lidocaine) ranging from 15:1 to 26:1. In septal cells, both drugs depressed upstroke velocity, and bupivacaine lengthened action potentials by up to 14%, but lidocaine did not. The major difference between bupivacaine and lidocaine in this study was the higher potency of the former agent with respect to electrophysiologic end-points.

UI MeSH Term Description Entries
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D009200 Myocardial Contraction Contractile activity of the MYOCARDIUM. Heart Contractility,Inotropism, Cardiac,Cardiac Inotropism,Cardiac Inotropisms,Contractilities, Heart,Contractility, Heart,Contraction, Myocardial,Contractions, Myocardial,Heart Contractilities,Inotropisms, Cardiac,Myocardial Contractions
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D006321 Heart The hollow, muscular organ that maintains the circulation of the blood. Hearts
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D000200 Action Potentials Abrupt changes in the membrane potential that sweep along the CELL MEMBRANE of excitable cells in response to excitation stimuli. Spike Potentials,Nerve Impulses,Action Potential,Impulse, Nerve,Impulses, Nerve,Nerve Impulse,Potential, Action,Potential, Spike,Potentials, Action,Potentials, Spike,Spike Potential
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001145 Arrhythmias, Cardiac Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction. Arrhythmia,Arrythmia,Cardiac Arrhythmia,Cardiac Arrhythmias,Cardiac Dysrhythmia,Arrhythmia, Cardiac,Dysrhythmia, Cardiac
D066298 In Vitro Techniques Methods to study reactions or processes taking place in an artificial environment outside the living organism. In Vitro Test,In Vitro Testing,In Vitro Tests,In Vitro as Topic,In Vitro,In Vitro Technique,In Vitro Testings,Technique, In Vitro,Techniques, In Vitro,Test, In Vitro,Testing, In Vitro,Testings, In Vitro,Tests, In Vitro,Vitro Testing, In

Related Publications

D M Wheeler, and E L Bradley, and W T Woods
June 1984, Anesthesia and analgesia,
D M Wheeler, and E L Bradley, and W T Woods
July 1992, The Journal of pharmacology and experimental therapeutics,
D M Wheeler, and E L Bradley, and W T Woods
January 1982, Journal of cardiovascular pharmacology,
D M Wheeler, and E L Bradley, and W T Woods
August 1995, Pharmacology & toxicology,
D M Wheeler, and E L Bradley, and W T Woods
August 1983, Anesthesia and analgesia,
D M Wheeler, and E L Bradley, and W T Woods
January 1991, Anesthesia and analgesia,
D M Wheeler, and E L Bradley, and W T Woods
February 1988, Anesthesia and analgesia,
D M Wheeler, and E L Bradley, and W T Woods
July 1971, The Journal of pharmacology and experimental therapeutics,
D M Wheeler, and E L Bradley, and W T Woods
October 1988, Anesthesia and analgesia,
Copied contents to your clipboard!